{"id":10300,"date":"2025-03-01T14:07:33","date_gmt":"2025-03-01T19:07:33","guid":{"rendered":"https:\/\/dhss.delaware.gov\/dph\/dhan328\/"},"modified":"2025-03-02T00:52:23","modified_gmt":"2025-03-02T05:52:23","slug":"dhan328","status":"publish","type":"page","link":"https:\/\/dhss.delaware.gov\/dph\/php\/alerts\/dhan328\/","title":{"rendered":"php\/alerts\/dhan328 ~  Division of Public Health &#8212; Health Alert  &#8211; Delaware Health and Social Services &#8211; State of Delaware"},"content":{"rendered":"<div data-swiftype-index=\"true\">\n\n\n\n  <br>\n\n\n\n  <div class=\"container\" id=\"main_header\"> \n\n    <!-- BEGIN readspeaker div -->\n\n    <div class=\"rs_skip rsbtn rs_preserve\" id=\"readspeaker_button1\">\n\n      <a accesskey=\"L\" class=\"rsbtn_play\" href=\"https:\/\/app-na.readspeaker.com\/cgi-bin\/rsent?customerid=7262&#038;lang=en_us&#038;readid=main_content&#038;url=https:\/\/dhss.delaware.gov\/dph\/php\/alerts\/dhan328.html\" title=\"Listen to this page using ReadSpeaker\">\n\n        <span class=\"rsbtn_left rsimg rspart\"><span class=\"rsbtn_text\"><span>Listen<\/span><\/span><\/span>\n\n        <span class=\"rsbtn_right rsimg rsplay rspart\"><\/span>\n\n      <\/a>\n\n    <\/div>\n\n    <!-- END readspeaker div -->\n\n\n\n    \n\n    <header class=\"pull-left\">\n\n      <h1>Delaware Health Alert Network #<!--[type=EDIT name=\"DHAN Number\"]-->328 <!--[END]--> <\/h1>\n\n      <h2> <!--[type=EDIT name=\"DHAN Date\"]-->June 23, 2014 8:42 am <!--[END]--> <\/h2>\n\n    <\/header>\n\n  <\/div><br>\n\n \n\n  <div class=\"container\">\n\n    <div class=\"row\">\n\n      <div class=\"col-md-3\" id=\"leftCol\">\n\n        <div class=\"panel-group\" id=\"accordion\">\n\n          <div class=\"panel sectionmenu_panel\">\n\n            <div class=\"panel-heading\">\n\n              <p class=\"panel-title\"><a class=\"agency_nav\" data-parent=\"#accordion\" data-toggle=\"collapse\" href=\"#collapseOne\"><strong><i class=\"fa fa-align-justify fa-fw\"><\/i> Public Health Menu<\/strong><\/a><\/p>\n\n            <\/div>\n\n\n\n            <div class=\"panel-collapse collapse in\" id=\"collapseOne\">\n\n              <div class=\"panel-body\" id=\"clf_nav\">\n\n                  <ul class=\"nav nav-stacked nav-pills-clf\" id=\"agency_sidebar\">\n    <li><a href=\"\/dph\/\"><h2>Home <i class=\"fa fa-home fa-fw\"><\/i><\/h2><\/a><\/li>\n    <li class=\"toplevel\"><a data-parent=\"#agency_sidebar\" data-toggle=\"collapse\" href=\"#HomeMenu\"><h2>About <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n      <ul class=\"panel-collapse collapse\" id=\"HomeMenu\">\n        <li><a href=\"\/dph\/about.html\">About DPH<\/a><\/li>\n        <li><a href=\"\/dph\/sections.html\">Sections &#038; Programs<\/a><\/li>\n        <li><a href=\"\/dph\/ofclocations.html\">Office Locations<\/a><\/li>\n        <li><a href=\"\/dph\/contact.html\">Contact Info<\/a><\/li>\n      \n        <li><a href=\"\/calendars.html\" target=\"_blank\">Calendar<\/a><\/li>\n      <\/ul>\n    <\/li>\n    <li class=\"toplevel\"><a data-parent=\"#sidebar\" data-toggle=\"collapse\" href=\"#ServicesMenu\"><h2>Services <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n      <ul class=\"panel-collapse collapse\" id=\"ServicesMenu\">\n        <li><a href=\"\/dph\/servicesaz.html\">A-Z Services<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/environmental.html\">Air &#038; Water Quality<\/a><\/li>\n        <li><a href=\"\/dph\/ss\/vitalstats.html\">Birth, Death, &#038; Marriage Records<\/a><\/li>\n        <li><a href=\"\/dph\/clinics.html\">Clinics<\/a><\/li>\n        <li><a href=\"\/dph\/healthdatastats.html\">Health Data &#038; Statistics<\/a><\/li>\n        <li><a href=\"\/dph\/php\/emsps.html\">Emergency Preparedness<\/a><\/li>\n        <li><a href=\"\/dph\/healthandwellness.html\">Health &#038; Wellness<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/healthyhomes.html\">Healthy Homes<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/healthywp.html\">Healthy Workplaces<\/a><\/li>\n        <li><a href=\"\/dph\/lab\/labs.html\">Laboratory<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/feir.html\">Restaurant Inspections<\/a><\/li>\n        <li><a href=\"\/dph\/screen.html\">Screening and Testing<\/a><\/li>\n        <li><a href=\"\/dph\/chca\/dphwichominf01.html\">WIC<\/a><\/li>\n        <li><a href=\"\/dph\/servicesadd.html\">Additional Services<\/a><\/li><li>\n      <\/li><\/ul>\n    <\/li>\n    <li class=\"toplevel\"><a data-parent=\"#sidebar\" data-toggle=\"collapse\" href=\"#InformationMenu\"><h2>Information <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n        <ul class=\"panel-collapse collapse\" id=\"InformationMenu\">\n        <li><a href=\"\/dph\/factsheetsaz.html\">A-Z Fact Sheets<\/a><\/li>\n        <li><a href=\"\/dph\/pubreportsaz.html\">A-Z Publications &#038; Reports<\/a><\/li>\n        <li><a href=\"\/dph\/diseasesandconditions.html\">Diseases &#038; 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The vaccine is routinely recommended for all\n\n\n  children, even when home-schooled, and is required for children attending any public or private school in Delaware. Adolescents, adults,\n\n\n  and especially persons such as health care workers who are at risk of exposing high-risk persons to measles, and persons traveling to\n\n\n  other parts of the world, are urged to be vaccinated against measles if they don\u2019t have proof of measles immunity (record of\n\n\n  previous vaccination or positive measles serological test results). Unvaccinated, immunocompromised persons and others at high risk of\n\n\n  complications from measles can be protected from measles, if exposed to a measles case, by post-exposure prophylaxis with Immune Globulin\n\n\n  if it can be given within 6 days of exposure.\n\n\n<\/p>\n\n\n<h3>\n\n\n  Background\n\n\n<\/h3>\n\n\n<p>\n\n\n  From January 1 &#8211; to June 13, 2014, there have been 477 confirmed measles cases reported to the Centers for Disease Control and Prevention\n\n\n  (CDC), by 20 states. Ohio has reported the highest numbers to date (311).\n\n\n<\/p>\n\n\n<p>\n\n\n  The Philippines is currently experiencing a large and ongoing outbreak with 40,000 cases and 40 deaths and most of the US cases have been\n\n\n  associated with imports from that country, though importation from other countries has also been documented. The majority of cases were\n\n\n  in individuals who were unvaccinated or of unknown vaccination status. A smaller group was of individuals too young to have been\n\n\n  vaccinated. The Ohio outbreak is affecting mostly their Amish community after the disease was brought back by travelers returning from\n\n\n  the Philippines.\n\n\n<\/p>\n\n\n<p>\n\n\n  Measles is one of the most contagious of all infectious diseases; approximately 90% of susceptible persons with close contact to a\n\n\n  measles patient will develop measles. The virus is transmitted by direct contact with infectious droplets or by airborne spread when an\n\n\n  infected person breathes, coughs, or sneezes. Measles virus can remain infectious on surfaces and in the air for up to two hours.\n\n\n<\/p>\n\n\n<p>\n\n\n  Measles is characterized by a prodrome of fever (as high as 105\u00b0F) and malaise, cough, coryza, and conjunctivitis, a pathognomonic\n\n\n  enanthema (Koplik spots) followed by a maculopapular rash. The rash usually appears about 14 days after a person is exposed; however, the\n\n\n  incubation period ranges from 7 to 21 days. The rash spreads from the head to the trunk to the lower extremities. Patients are considered\n\n\n  to be contagious from 4 days before to 4 days after the rash appears. Of note, immunocompromised patients may not develop the rash.\n\n\n<\/p>\n\n\n<h3>\n\n\n  Recommendations\n\n\n<\/h3>\n\n\n<p>\n\n\n  Delaware has not experienced an increase in reported measles cases. However, DPH is being proactive by recommending that providers take\n\n\n  the following action:\n\n\n<\/p>\n\n\n<ul>\n\n\n  <li>Consider measles in patients presenting with febrile rash illness and clinically compatible measles symptoms, especially if the\n\n\n  person recently traveled internationally, was exposed to a person with febrile rash illness or had contact with international visitors.\n\n\n  <\/li>\n\n\n  <li>Institute respiratory and airborne precautions immediately for all patients with febrile rash or suspect measles.\n\n\n  <\/li>\n\n\n  <li>Obtain specimens for confirmation of the diagnosis.\n\n\n  <\/li>\n\n\n  <li>IMMEDIATELY report any suspect measles cases in Delaware to DPH\u2019s Office of Infectious Disease Epidemiology at 1(888) 295-5156\n\n\n  or (302) 744-1033. Do NOT wait for laboratory confirmation before reporting a suspected case.\n\n\n  <\/li>\n\n\n  <li>Strongly advise all citizens considering international travel to ensure they are up-to-date with their vaccinations. Though the\n\n\n  Philippines may appear to be the main origin for the current outbreak in Ohio, measles is fairly widespread outside the US.\n\n\n  <\/li>\n\n\n  <li>Ensure all patients\u2019 vaccinations (including measles) are up-to date.\n\n\n  <\/li>\n\n\n<\/ul>\n\n\n<h3>\n\n\n  Additional Information\n\n\n<\/h3>\n\n\n<p>\n\n\n  Suspect measles cases needing medical attention should not be allowed in patient waiting areas. They should be masked and placed\n\n\n  immediately in an examination room, with the door closed. The examination room in which a patient with suspected or confirmed measles was\n\n\n  examined should cleaned and not be used again for at least two hours. With hospitalized patients, respiratory isolation is recommended\n\n\n  for 4 days after the onset of rash.\n\n\n<\/p>\n\n\n<p>\n\n\n  Listings of all exposed patients and staff will be required by DPH from any medical facility treating a case of measles.\n\n\n<\/p>\n\n\n<h3>\n\n\n  Collecting Specimens\n\n\n<\/h3>\n\n\n<p>\n\n\n  Blood specimens for both measles IgM and IgG antibodies should be obtained at the time of clinical presentation. Oropharyngeal or\n\n\n  nasopharyngeal swabs are the preferred samples for virus isolation or detection of measles RNA by RT\u2013PCR. Synthetic swabs are\n\n\n  recommended. Urine samples may also contain virus and collection of both samples can increase the likelihood of detecting the virus. The\n\n\n  sample should be collected at the first contact with a suspected case when the serum sample for diagnosis is drawn.\n\n\n<\/p>\n\n\n<p>\n\n\n  Though detection of measles RNA and measles virus isolation are most successful when samples are collected on day 1 through day 3\n\n\n  following onset of rash, virus may still be recovered by cell culture through day 10 following rash onset. Detection of measles RNA by\n\n\n  RT\u2013PCR may be successful as late as 10\u201314 days post rash onset.\n\n\n<\/p>\n\n\n<p>\n\n\n  For information on measles or to report a suspected case call the DPH Office of Infectious Disease Epidemiology at 302-744-1033 or visit:\n\n\n  <a href=\"http:\/\/www.cdc.gov\/measles\">http:\/\/www.cdc.gov\/measles<\/a>.\n\n\n<\/p>\n\n\n<p>\n\n\n  For information on measles vaccine call the Delaware Immunization Program at 302-744-1060.\n\n\n<\/p>\n\n\n<p>\n\n\n  ************************************\n\n\n<\/p>\n\n\n<p>\n\n\n  You are receiving this email because you are a registered member of the Delaware Health Alert Network. If you are not a member and would\n\n\n  like to subscribe, please register at <a href=\"https:\/\/healthalertde.org\">https:\/\/healthalertde.org<\/a>\n\n\n<\/p><!--[END]-->\n\n  \n\n        <div class=\"panel panel-danger\">\n\n          <div class=\"panel-heading\">    \n\n      <h2>Categories of Health Alert messages:<\/h2>\n\n       <\/div>\n\n       <div class=\"panel-body\">\n\n      <ul>\n\n        <li><strong>Health Alert:<\/strong> Conveys the highest level of importance; warrants immediate action or attention.<\/li>\n\n        <li><strong>Health Advisory:<\/strong> Provides important information for a specific incident or situation; may not require immediate action.<\/li>\n\n        <li><strong>Health Update:<\/strong> Provides updated information regarding an incident or situation; unlikely to require immediate action.<\/li>\n\n            <\/ul>\n\n         <div><strong>NOTE: This page is for informational purposes only and dated material (e.g. temporary websites) may not be available.<\/strong><\/div>\n\n          <\/div> \n\n        <\/div><br>  \n\n\n\n      <\/div>\n\n    <\/div>\n\n  <\/div><!-- \/container -->\n\n  <\/div>","protected":false},"excerpt":{"rendered":"<p>Listen Delaware Health Alert Network #328 June 23, 2014 8:42 am Public Health Menu Home About About DPH Sections &#038; Programs Office Locations Contact Info Calendar Services A-Z Services Air &#038; Water Quality Birth, Death, &#038; Marriage Records Clinics Health Data &#038; Statistics Emergency Preparedness Health &#038; Wellness Healthy Homes Healthy Workplaces Laboratory Restaurant Inspections [&hellip;]<\/p>\n","protected":false},"author":8,"featured_media":0,"parent":9294,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"class_list":["post-10300","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10300","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/comments?post=10300"}],"version-history":[{"count":1,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10300\/revisions"}],"predecessor-version":[{"id":11476,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10300\/revisions\/11476"}],"up":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/9294"}],"wp:attachment":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/media?parent=10300"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}